Migraine is a complex neurological condition that can cause a variety of symptoms. In addition to a severe headache, migraines can involve nausea, fatigue, and sensitivity to light and sound.
There are four stages of a migraine: the prodromal stage, aura, headache pain, and postdrome stage.
A migraine can last anywhere from a few hours to days. The overall duration varies because each phase has its own time range.
Because they are such a complex condition, scientists don't fully understand migraines.
People with migraines can have very different experiences, with symptoms and their severity varying from person to person. In fact, migraine attacks may not involve every stage.
The latest on migraines
Similar to some other neurological conditions, researchers don’t fully understand what causes migraines. While the science behind it is constantly evolving, recent studies have provided insights into how migraines might form.
Researchers previously thought migraines were caused by blood vessel issues. But recent evidence has shown that different parts of your nervous system are involved in them.
Scientists have also identified certain genes that may play a role in whether or not you get migraines. Research is ongoing, but these developments may help with new treatments down the road.
The four stages of a migraine
Migraines are different for each person, but in general, there are four stages of a migraine: the prodromal stage, aura, headache pain, and postdrome stage.
1. Prodromal stage
Often called the “pre-headache” stage, the prodrome is the first phase of a migraine. While migraines can be spontaneous, this phase can be a warning sign for an upcoming attack. It typically occurs a day or two before the onset of a headache.
Everyone experiences migraines differently, but common symptoms in this phase include:
mood changes
fatigue
neck pain
food cravings
vision difficulties
light or sound sensitivity
Noticing this phase early and getting treatment may help prevent a migraine altogether. If you know your migraine triggers, avoid them when possible.
Prevention looks different for each person, but drinking plenty of water, eating regular, healthy meals, and finding a relaxing environment may help prevent a migraine.
2. Aura
The second phase, aura, can occur before or alongside a headache. Aura typically arises gradually and can last anywhere from a few minutes to an hour.
Not everyone will go through this phase, but those who do may experience sensory symptoms, such as:
visual field issues
visions such as bright lines
ringing in the ears
tingling or numbness
weakness on one side of the body or face
If aura develops before the onset of a headache, you may be able to prevent the migraine from happening. But not all migraines involve aura.
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3. Headache pain
The headache phase of a migraine is a distinct throbbing pain usually on just one side of the head. Migraine headaches can last for a few hours to several days.
While a severe headache is a hallmark, you may also experience other symptoms, such as:
nausea
vomiting
sensitivity to light or sound
runny nose
pain sensitivity
As with the other phases, what helps during the headache phase will be unique to each person. For some people, taking a nap in a cool, dark, and quiet room can provide relief.
4. Postdrome phase
The period immediately after the headache phase is known as the postdrome phase. This phase typically lasts 1–2 days after the headache pain ends.
Symptoms during this phase vary, but common symptoms include:
fatigue
difficulty concentrating
dizziness
mood changes
You may find some relief by practicing self-care during this phase. Avoid stress where possible and try participating in a relaxing activity.
When should I be worried?
You may want to seek advice from your healthcare provider if your migraines:
occur once a week or more
are disrupting your work or personal life
are causing you to take medication more than twice a week, including for other headaches
Seek immediate care if you experience any of the following symptoms alongside your migraine:
fever
muscle weakness
blurred vision
seeing double
confusion
symptoms that are unusual for you
Also, seek urgent medical attention if you experience abnormal migraine symptoms and are pregnant or have another health condition, such as:
heart problems
kidney or liver disease
an immune system condition
Migraine prevention
What prevents a migraine will be different from person to person, but following some general tips may be helpful.
Research suggests that stress is a leading trigger for migraines.
Mindfulness therapy, such as cognitive behavioral therapy and acceptance and commitment therapy, may help some people.
Being physically active can also help. Scientists have found links between aerobic activity — the kind that gets your heart pumping — and improved pain, length, and frequency of migraines.
However, some people find that physical activity can also trigger a migraine, so be mindful of what works best for you.
If you're experiencing severe migraines frequently, your doctor may also suggest a long-term medication to help prevent them from happening. Discuss which option is best for you with your healthcare provider.
Summary
There are generally four phases of a migraine: the prodrome, aura, headache, and postdrome phase. In total, this can last anywhere from a couple of days to a week, but each stage has its own time duration range.
Typically the prodromal stage will last 1–2 days. The second stage, aura, is usually finished within 1 hour.
The painful headache stage is particularly variable in duration, lasting anywhere from a few hours to several days.
Like the prodromal stage, the postdrome stage usually lasts 1–2 days.
However, not every migraine will involve each stage. Similarly, migraine symptoms, phases, severity, and effective treatments will vary from person to person.
Sources
Acceptance and commitment therapy for primary headache sufferers: a randomized controlled trial of efficacy. Journal of Pain. (2021). https://pubmed.ncbi.nlm.nih.gov/32682815/
Cognitive behavioral therapy for migraine headache: a systematic review and meta-analysis. Medicina. (2022). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8777662
Is aerobic exercise helpful in patients with migraines? a systematic review and meta analysis. Scandinavian Journal of Medicine and Science in Sports. (2020). https://pubmed.ncbi.nlm.nih.gov/31904889/
Migraine headache. StatPearls. (2022). https://www.ncbi.nlm.nih.gov/books/NBK560787/
Migraine prodrome: symptoms and prevention. (2022). https://americanmigrainefoundation.org/resource-library/migraine-prodrome-symptoms-prevention/
Migraine with aura. StatPearls. (2021). https://www.ncbi.nlm.nih.gov/books/NBK554611/
Preventive migraine treatment. Continuum. (2015). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4640499/
The migraine postdrome. Neurology. (2016). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955275/
The pathophysiology of migraine: implications for clinical management. The Lancet Neurology. (2018). https://pubmed.ncbi.nlm.nih.gov/29229375/
What turns on a migraine? a systematic review of migraine precipitating factors. Current Pain and Headache Reports. (2014). https://pubmed.ncbi.nlm.nih.gov/25160711/
When to go to the emergency room for a headache or migraine. (2017). https://americanmigrainefoundation.org/resource-library/when-to-go-to-the-er-for-headache-migraine
When should I see a doctor about migraines? (2017). https://americanmigrainefoundation.org/resource-library/when-should-i-see-a-doctor-about-migraines/